Poulsen CH, et al. – This study explored the link between an irritable bowel syndrome (IBS) symptom continuum and the subsequent development of common mental disorders (CMDs) and functional somatic syndromes (FSSs). In the context of this association, clinicians must broaden their perspectives to individuals not fulfilling the symptom cluster of IBS but who report frequent abdominal pain. A combination of symptom–based criteria of IBS and psychosocial markers such as mental vulnerability is crucial to make decisions regarding prognosis and treatment.

Methods

• A longitudinal population-based study comprising two 5-year follow-up studies, Dan-MONICA 1 (1982–1987) and Inter99 (1999–2004), recruited from the western part of Copenhagen County.
• Researchers categorized the total study population (n = 7,278) into symptom groups according to the degree of IBS definition fulfillment at baseline and/or follow-up and followed until December 2013 in Danish central registries.
• They used Cox regression for the analyses, adjusting for age, sex, length of education and cohort membership.
• In a subsequent analysis, they adjusted for mental vulnerability as a risk factor for both CMDs and FSSs, including IBS.

Results

• Findings demonstrated that over a 5-year period, 51% patients had no IBS symptoms, 17% patients had IBS symptoms without abdominal pain, 22% patients had IBS symptoms including abdominal pain and 10% patients fulfilled the IBS definition.
• Researchers found that IBS and IBS symptoms including abdominal pain were significantly associated with the development of CMDs and other FSSs identified in secondary care.
• They noted that, when adjusting for mental vulnerability, IBS and IBS symptoms including abdominal pain were no longer associated with CMDs, but the significant relationship to other FSSs remained.